Provider Demographics
NPI:1467872069
Name:GELBART, MINDY (OD)
Entity Type:Individual
Prefix:DR
First Name:MINDY
Middle Name:
Last Name:GELBART
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 LAMBERT RDG
Mailing Address - Street 2:
Mailing Address - City:CROSS RIVER
Mailing Address - State:NY
Mailing Address - Zip Code:10518-1125
Mailing Address - Country:US
Mailing Address - Phone:914-763-2263
Mailing Address - Fax:
Practice Address - Street 1:44 LAMBERT RDG
Practice Address - Street 2:
Practice Address - City:CROSS RIVER
Practice Address - State:NY
Practice Address - Zip Code:10518-1125
Practice Address - Country:US
Practice Address - Phone:914-763-2263
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-22
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004664152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist